The role of dupilumab in managing allergic contact dermatitis
Main Article Content
Keywords
dermatology, dupilumab, allergic contact dermatitis, eczema, immunosuppression, pharmacology, biologic, treatment
Abstract
Recently, there has been vigorous debate about the value of using dupilumab, a biologic that targets TH2-mediated processes, in the management of recalcitrant allergic contact dermatitis. A review of the current literature found the following: 1) The cytokine polarity of the immunologic response in ACD depends upon the inciting allergen, so the therapeutic approach to ACD must be individualized; 2) a single allergen can elicit different immunological responses in patients with and without underlying AD; 3) there is limited evidence in support of using dupilumab for ACD in patients without concomitant AD; 4) the cost of this drug further argues against its use in all patients with ACD; 5) dupilumab’s benign side effect profile, particularly its lack of immunosuppression, relative to other systemic therapies make it a reasonable option in AD patients with systemic ACD to certain allergens known to elicit a significant type 2 immune response who have failed other treatments.
References
1. Peiser M, Tralau T, Heidler J, et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci. 2012;69(5):763-781.
2. Kadyk DL, McCarter K, Achen F, Belsito D V. Quality of life in patients with allergic contact dermatitis. J Am Acad Dermatol. 2003;49(6):1037-1048.
3. Nixon RL, Mowad CM, Marks JG. Allergic contact dermatitis. In: Bolognia J, Schaffer J, Cerroni L, eds. Dermatology. 4th ed. Philadelphia: Elsevier; 2018:242-261.
4. Rowe A, Bunker CB. Interleukin-4 and the interleukin-4 receptor in allergic contact dermatitis. Contact Dermatitis. 1998;38(1):36-39.
5. Traidl C, Jugert F, Krieg T, Merk H, Hunzelmann N. Inhibition of allergic contact dermatitis to DNCB but not to oxazolone in interleukin-4-deficient mice. J Invest Dermatol. 1999;112(4):476-482.
6. Nagai H, Ueda Y, Ochi T, et al. Different role of IL-4 in the onset of hapten-induced contact hypersensitivity in BALB/c and C57BL/6 mice. Br J Pharmacol. 2000;129(2):299-306.
7. Campos RA, Szczepanik M, Itakura A, et al. Interleukin-4-dependent innate collaboration between iNKT cells and B-1 B cells controls adaptative contact sensitivity. Immunology. 2006;117(4):536-547.
8. Niiyama S, Tamauchi H, Amoh Y, et al. Th2 immune response plays a critical role in the development of nickel-induced allergic contact dermatitis. Int Arch Allergy Immunol. 2010;153(3):303-314.
9. Dhingra N, Shemer A, Correa da Rosa J, et al. Molecular profiling of contact dermatitis skin identifies allergen-dependent differences in immune response. J Allergy Clin Immunol. 2014;134(2):362-372.
10. Sung CT, McGowan MA, Machler BC, Jacob SE. Systemic treatments for allergic contact dermatitis. Dermatitis. 2019;30(1):46-53.
11. Dupixent (dupilumab) injection. 2017. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/761055lbl.pdf.
12. Hamilton JD, Suárez-Fariñas M, Dhingra N, et al. Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol. 2014;134(6):1293-1300.
13. Puza CJ, Atwater AR. Positive patch test reaction in a patient taking dupilumab. Dermat contact, atopic, Occup drug. 2018;29(2):89.
14. Joshi SR, Khan DA. Effective use of dupilumab in managing systemic allergic contact dermatitis. Dermat contact, atopic, Occup drug. 2018;29(5):282-284.
15. Chipalkatti N, Lee N, Zancanaro P, Dumont N, Donovan C, Rosmarin D. Dupilumab as a treatment for allergic contact dermatitis. Dermat contact, atopic, Occup drug. 2018;29(6):347-348.
16. Correa da Rosa J, Malajian D, Shemer A, et al. Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin. J Allergy Clin Immunol. 2015;135(3):712-720.
17. Machler BC, Sung CT, Darwin E, Jacob SE. Dupilumab use in allergic contact dermatitis. J Am Acad Dermatol. 2019;80(1):280-281.e1.
18. Goldminz AM, Scheinman PL. A case series of dupilumab-treated allergic contact dermatitis patients. Dermatol Ther. 2018;31(6):e12701.
19. Jacob SE, Sung CT, Machler BC. Dupilumab for systemic allergy syndrome with dermatitis. Dermat contact, atopic, Occup drug. 2019;30(2):164-167.
20. Chipalkatti N, Lee N, Zancanaro P, Dumont N, Kachuk C, Rosmarin D. A retrospective review of dupilumab for atopic dermatitis patients with allergic contact dermatitis. J Am Acad Dermatol. 2019;80(4):1166-1167.
21. Collantes-Rodríguez C, Jiménez-Gallo D, Ossorio-García L, Villegas-Romero I, Linares-Barrios M. Recall dermatitis at patch test sites in an atopic dermatitis patient treated with dupilumab. Contact Dermatitis. 2019;80(1):69-70.
22. Huynh T, Hadi S, Tan K, Guttman-Yassky E. Dupilumab therapy for chronic refractory hand dermatitis [abstract]. Exp Dermatol. 2018;27(S2):33.
23. Crepy M-N, Nosbaum A, Bensefa-Colas L. Blocking type 2 inflammation by dupilumab does not control classic (Type 1-driven) allergic contact dermatitis in chronic hand eczema. Contact Dermatitis. March 2019.
24. Stout M, Silverberg JI. Variable impact of dupilumab on patch testing results and allergic contact dermatitis in adults with atopic dermatitis. J Am Acad Dermatol. March 2019.
25. Hoot JW, Douglas JD, Falo LD. Patch testing in a patient on dupilumab. Dermatitis. 2018;29(3):164.
26. Ou Z, Chen C, Chen A, Yang Y, Zhou W. Adverse events of dupilumab in adults with moderate-to-severe atopic dermatitis: a meta-analysis. Int Immunopharmacol. 2018;54:303-310.
27. Simpson EL, Bieber T, Guttman-Yassky E, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335-2348.
28. Zimmermann M, Rind D, Chapman R, Kumar V, Kahn S, Carlson J. Economic evaluation of dupilumab for moderate-to-severe atopic dermatitis: a cost-utility analysis. J Drugs Dermatol. 2018;17(7):750-756.
2. Kadyk DL, McCarter K, Achen F, Belsito D V. Quality of life in patients with allergic contact dermatitis. J Am Acad Dermatol. 2003;49(6):1037-1048.
3. Nixon RL, Mowad CM, Marks JG. Allergic contact dermatitis. In: Bolognia J, Schaffer J, Cerroni L, eds. Dermatology. 4th ed. Philadelphia: Elsevier; 2018:242-261.
4. Rowe A, Bunker CB. Interleukin-4 and the interleukin-4 receptor in allergic contact dermatitis. Contact Dermatitis. 1998;38(1):36-39.
5. Traidl C, Jugert F, Krieg T, Merk H, Hunzelmann N. Inhibition of allergic contact dermatitis to DNCB but not to oxazolone in interleukin-4-deficient mice. J Invest Dermatol. 1999;112(4):476-482.
6. Nagai H, Ueda Y, Ochi T, et al. Different role of IL-4 in the onset of hapten-induced contact hypersensitivity in BALB/c and C57BL/6 mice. Br J Pharmacol. 2000;129(2):299-306.
7. Campos RA, Szczepanik M, Itakura A, et al. Interleukin-4-dependent innate collaboration between iNKT cells and B-1 B cells controls adaptative contact sensitivity. Immunology. 2006;117(4):536-547.
8. Niiyama S, Tamauchi H, Amoh Y, et al. Th2 immune response plays a critical role in the development of nickel-induced allergic contact dermatitis. Int Arch Allergy Immunol. 2010;153(3):303-314.
9. Dhingra N, Shemer A, Correa da Rosa J, et al. Molecular profiling of contact dermatitis skin identifies allergen-dependent differences in immune response. J Allergy Clin Immunol. 2014;134(2):362-372.
10. Sung CT, McGowan MA, Machler BC, Jacob SE. Systemic treatments for allergic contact dermatitis. Dermatitis. 2019;30(1):46-53.
11. Dupixent (dupilumab) injection. 2017. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/761055lbl.pdf.
12. Hamilton JD, Suárez-Fariñas M, Dhingra N, et al. Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol. 2014;134(6):1293-1300.
13. Puza CJ, Atwater AR. Positive patch test reaction in a patient taking dupilumab. Dermat contact, atopic, Occup drug. 2018;29(2):89.
14. Joshi SR, Khan DA. Effective use of dupilumab in managing systemic allergic contact dermatitis. Dermat contact, atopic, Occup drug. 2018;29(5):282-284.
15. Chipalkatti N, Lee N, Zancanaro P, Dumont N, Donovan C, Rosmarin D. Dupilumab as a treatment for allergic contact dermatitis. Dermat contact, atopic, Occup drug. 2018;29(6):347-348.
16. Correa da Rosa J, Malajian D, Shemer A, et al. Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin. J Allergy Clin Immunol. 2015;135(3):712-720.
17. Machler BC, Sung CT, Darwin E, Jacob SE. Dupilumab use in allergic contact dermatitis. J Am Acad Dermatol. 2019;80(1):280-281.e1.
18. Goldminz AM, Scheinman PL. A case series of dupilumab-treated allergic contact dermatitis patients. Dermatol Ther. 2018;31(6):e12701.
19. Jacob SE, Sung CT, Machler BC. Dupilumab for systemic allergy syndrome with dermatitis. Dermat contact, atopic, Occup drug. 2019;30(2):164-167.
20. Chipalkatti N, Lee N, Zancanaro P, Dumont N, Kachuk C, Rosmarin D. A retrospective review of dupilumab for atopic dermatitis patients with allergic contact dermatitis. J Am Acad Dermatol. 2019;80(4):1166-1167.
21. Collantes-Rodríguez C, Jiménez-Gallo D, Ossorio-García L, Villegas-Romero I, Linares-Barrios M. Recall dermatitis at patch test sites in an atopic dermatitis patient treated with dupilumab. Contact Dermatitis. 2019;80(1):69-70.
22. Huynh T, Hadi S, Tan K, Guttman-Yassky E. Dupilumab therapy for chronic refractory hand dermatitis [abstract]. Exp Dermatol. 2018;27(S2):33.
23. Crepy M-N, Nosbaum A, Bensefa-Colas L. Blocking type 2 inflammation by dupilumab does not control classic (Type 1-driven) allergic contact dermatitis in chronic hand eczema. Contact Dermatitis. March 2019.
24. Stout M, Silverberg JI. Variable impact of dupilumab on patch testing results and allergic contact dermatitis in adults with atopic dermatitis. J Am Acad Dermatol. March 2019.
25. Hoot JW, Douglas JD, Falo LD. Patch testing in a patient on dupilumab. Dermatitis. 2018;29(3):164.
26. Ou Z, Chen C, Chen A, Yang Y, Zhou W. Adverse events of dupilumab in adults with moderate-to-severe atopic dermatitis: a meta-analysis. Int Immunopharmacol. 2018;54:303-310.
27. Simpson EL, Bieber T, Guttman-Yassky E, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335-2348.
28. Zimmermann M, Rind D, Chapman R, Kumar V, Kahn S, Carlson J. Economic evaluation of dupilumab for moderate-to-severe atopic dermatitis: a cost-utility analysis. J Drugs Dermatol. 2018;17(7):750-756.
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Published
Jul 8, 2019
Article Details
How to Cite
Desrosiers, A., Huynh, T., Helms, S., & Brodell, R. (2019). The role of dupilumab in managing allergic contact dermatitis. SKIN The Journal of Cutaneous Medicine, 3(4), 234–238. https://doi.org/10.25251/skin.3.4.1
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Clinical Management Recommendations
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